Here’s a bit more about what we hope to do over the coming year to address this issue….

The impact of any form of drug promotion on prescribing behaviour is incredibly hard to measure. It is much easier to measure the level of drug promotion that doctors are exposed to, or to survey their attitudes towards it, but to make associations between level of exposure and poorer prescribing habits is really tricky. However, there is clear evidence linking exposure to drug promotion with changes in prescribing behaviour - more often than not, increased exposure has resulted in prescribing less appropriately, over-prescribing and adopting new drugs more quickly (See page viii of WHO ‘Drug Promotion: What we know, what we have yet to learn’ http://apps.who.int/medicinedocs/en/d/Js8109e/)

Moreover, there is a stack of evidence to suggest that information provided by the pharmaceutical industry is often misleading and overstates the benefits of drugs whilst understating the risks.

(If you’re not convinced then check out Healthy Skepticism’s resource database for more evidence:http://www.healthyskepticism.org/global/library/favorites/PRM)

So if we know that being exposed to drug promotion can be detrimental to the current practice of qualified doctors, then it is not unreasonable to expect that exposure during medical training may also be detrimental to future practice: even though students will not be prescribing yet, early exposure to any form of drug promotion (including sponsorship to events or attendance to pharma-funded conferences) may reduce their scepticism of drug promotion and lead to more reliance on free gifts/sponsorship in the future.

PharmAware is really keen to gather more evidence about levels of exposure to drug promotion amongst the medical student population and to survey students’ attitudes towards it. From the few studies that have been conducted in the past (mainly in the US), students have reported feeling that they have inadequate training on this topic. We hypothesise that similar results will be mirrored in UK medical schools. Professor Sierles et al. conducted a large study of 8 US med schools in 2003 (http://jama.ama-assn.org/content/294/9/1034.full). We have been in contact with Prof Sierles and have permission to adapt the survey used in 2003 for use in the UK.

Our hope is that by learning more about students’ attitudes, we can adopt more evidence-based methods of campaigning and tailor our efforts as a Medsin activity towards the needs and reported requests of students. We hope this will exactly be a form of quiet diplomacy and will be more effective than getting on our high horse and preaching at students. Even just by asking them to fill out a survey it will get the ball rolling with raising awareness amongst medical students about drug promotion.

Over and above PharmAware activities, there is a new group being developed called ‘Conflict Free Conferences’ which has become affiliated with Healthy Skepticism. It is a promising initiative and worth reading more about (and potentially getting involved in?!) http://www.conflictfreeconferences.com/

 If after reading Felicity’s blog or this one, you want to read more then check out the resources pages on www.pharmaware.co.uk (currently being updated!!) or if you feel prompted to get more involved in pharma issues then please get in touch with me and Emily – pharmaware@gmail.com

We really need fresh ideas and more students on board!

Cheers J

http://www.abpi.org.uk/our-work/library/industry/Pages/joint-statement.aspx

Emergency Medicine Australasia announced that they will stop accepting pharmaceutical advertisement. They say that the move is a response to growing evidence about the effects of the drug industry in medicine and claims that industry distorts research findings.

BMJ 2011 342 d884

The NHS in England could save £200m a year if it switched patients with hypertension from candesartan to losartan without any loss of clinical benefits. BMJ 2011 342, d890

Pfizer is planning to close its research and development plan in Kent as part of a plan to trim research spending from over $8bn to less than $7bn. They plan to focus on areas that offer the greatest promise such as cancer and vaccines.

BMJ 2011 342, d771

BMJ 2010, 341, c6883